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S Uffer

Publications and source records attributed to S Uffer.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Combined surgery, cryocoagulation and radiotherapy for treatment of melanoma of the conjunctiva].

BACKGROUND: Conjunctival melanomas are malignant tumors with a high local recurrence rate after simple surgical excision. The rate of recurrence is particularly high in cases of large size tumor, of widespread tumors and with PAM associated lesions. Tumor recurrences have a bad long-term prognostic significance and often necessitate exenteration. PATIENTS AND METHODS: A method of therapy combining total surgical excision with proton-beam irradiation, cobalt plaque irradiation and cryotherapy is described. This technique is used in particular unfavorable cases with the aim of lowering the rate of recurrences. It was practiced in 19 cases in Lausanne, 10 of which were recurrent tumors. The melanoma invaded 3 quadrants of the bulbar conjunctiva in 8 cases and 4 quadrants in 11 cases. At least one neighbouring tarsal conjunctiva was invaded in 11 cases and both in 7 cases. The skin of the eyelid was infiltrated in 6 cases and the caruncle in 9 cases. Tumor thickness was 1 to 2 mm in 8 cases, 3 to 4 mm in 4 cases and 5 to 10 mm in 7 cases. RESULTS: PAM was present in 16 cases. Follow-up period was less than 1 year in 2 cases, between 1 to 2 years in 5 cases, between 2 to 3 years in 5 cases and more than 3 years in 7 cases. 5 patients had lymph node metastases, 3 died of metastatic disease and 2 had a local recurrence. One of these recurrences was small-sized and was excised, the other was widespread and the patient died soon with metastatic disease. No exenteration was performed. CONCLUSION: The method of therapy that is here described appears to be a valuable alternative to exenteration of the orbit for the treatment of diffuse or large-size conjunctival melanomas which have a high risk of local recurrence.

Adult↗
PubMed1994

[Bilateral conjunctivo-palpebral tumor in an immunocompetent man cause by human papilloma virus].

A 46-year-old white male patient in good general health presented with a bilateral conjunctival and eyelid tumor and a wart at the tip of the fourth right finger. Impression cytology showed dysplasic cells with loss of cohesion and up to 4 nucleoli per nucleus. The excisional biopsy of the conjunctiva revealed a dysplasic epithelial tissue that allowed the diagnosis of papilloma with parts of conjunctival intraepithelial neoplasia (CIN). Papilloma has been associated with Human Papillomavirus (HPV). The molecular hybridization analysis using PCR revealed that HPV was present in the eye tumor and in the wart, but the viral type was not the same. Treatment of the eye tumor with excision and low temperature cryocoagulation was successful.

Biopsy↗
PubMed1994

Primary gelatinous drop-like corneal dystrophy in a white woman. A pathologic, ultrastructural, and immunohistochemical study.

A white female with primary gelatinous drop-like corneal dystrophy (PGDD) was followed from the ages of 8 to 37 years. During this time, she underwent repeated lamellar and penetrating keratoplasties on both sides due to relapsing bilateral corneal opacifications. The diagnosis of PGDD was based on the histology of the corneal specimens obtained at 10 and 36 years of age, as well as on the characteristic clinical appearance and course. Electron microscopy showed typical amyloid fibrils. Immunohistochemical staining was mildly positive for amyloid AL (light chain), but negative for amyloid AA, AF, AB, and keratin. Thus, the precursor protein of the amyloid deposits in PGDD might derive from immunoglobulins, e.g., from the tear film. However, the precursor protein might derive from a different origin altogether. In that case, the positive staining for amyloid AL would translate nonspecific absorption of fragments of light chains.

Adult↗
PubMed1993

Orbital infarction syndrome.

BACKGROUND: The authors define orbital infarction as ischemia of all intraorbital and intraocular structures. It is a rare disorder due to the rich anastomotic vascularization of the orbit. PATIENTS: The authors report three patients with orbital infarction with similar clinical presentations: acute blindness, orbital pain, total ophthalmoplegia, and anterior and posterior segment ischemia. RESULTS: Etiologies of orbital infraction syndrome include occlusion of the common carotid artery (case 1), giant-cell arteritis (case 2), and mucormycosis (case 3). CONCLUSION: Three cases discussed in this article illustrate that orbital infarction is a disorder that can occur secondary to different mechanisms such as (1) acute perfusion failure (e.g., common carotid artery occlusion [possibly combined with anomalous orbital anastomotic channels]), 2) systemic vasculitis (e.g., giant-cell arteritis), and (3) orbital cellulitis with vasculitis (mucormycosis). The blindness and retinal and optic nerve damage were permanent, whereas the other signs of orbital ischemia (ophthalmoplegia and anterior segment ischemia) resolved. Therefore, diagnosis of orbital infarction can best be made during the acute phase.

Aged↗
PubMed1993

Retinoblastoma. Unusual warning and clinical signs.

Three clinical cases have been chosen to illustrate the pitfalls that can be encountered when warning signs other than leukokoria or strabismus indicate possible retinoblastoma. The first case, a four-year-old boy, was admitted to hospital after an accident, presenting uveitis, glaucoma and a subluxated lens. He was suffering from unilateral retinoblastoma, already exteriorized and the cause of death some months later. The second case, and 11-month-old female child was seen on fundus examination to present a yellowish elevated calcified mass which turned out to be tuberous sclerosis. The third patient, a 43-year-old male, father of two children suffering from retinoblastoma, was found on routine examination to be carrying a partially-calcified retinal tumour. Subsequent haemorrhaging rendered enucleation necessary and microscopic examination confirmed the diagnosis of retinoma. The diagnosis of retinoblastoma should always be kept in mind whenever an intraocular mass is revealed or where there are unexplained atypical ocular signs.

Adolescent↗
PubMed1992

Natural history of diffuse uveal melanocytic proliferation. Case report.

BACKGROUND: Diffuse uveal melanocytic proliferation is a rare paraneoplastic syndrome resulting in rapid bilateral visual loss due to proliferation of benign melanocytes within the choroid and ciliary body. Most of the previously reported cases have been seen with bilateral involvement and typical ocular features. PATIENT: The authors report the case of a 61-year-old man who presented with uniocular posterior pole lesions at the level of the retinal pigment epithelium and subsequently developed the typical bilateral lesions of diffuse uveal melanocytic proliferation. His clinical course was typical, with visual disturbance preceding signs and symptoms of malignancy by 5 months. Rapid decline ensued, and he eventually died 10 months after the onset of visual symptoms. RESULTS: Results of ocular pathologic examination showed the typical choroidal thickening due to the proliferation of melanocytes and the primary tumor was found to be an undifferentiated adenocarcinoma originating in either the pancreas or the esophagus. CONCLUSIONS: The very early funduscopic and fluorescein angiographic findings of diffuse uveal melanocytic proliferation are presented as well as the evolution, ocular pathology, and possible mechanisms for its development.

Cell Division↗
PubMed1992

[The unsolved problem of transplant astigmatism].

Irregularities of the trephine margins, donor/recipient thickness disparity and irregular suture technique are the important factors for high astigmatism after penetrating keratoplasty. A combined suture technique using eight interrupted 11-0 Mersilene sutures and a single continuous 10-0 nylon suture enables to control and to remedy the final postkeratoplasty astigmatism. In 35 patients with a corneal graft a final astigmatism of 2.9 diopters was reached after removal of the continuous suture and partial leaving in place of single interrupted Mersilene sutures.

Astigmatism↗
PubMed1992

[Uveal melanomas in patients less than 20 years of age].

During the past 15 years we observed 21 uveal tumors in patients aged 20 years and younger. Four of them were younger than 10 years, 4 were 11 to 15 years' old, 4 ranged from 16-17 years and 9 from 18-20 years. An accelerated beam irradiation was applied in 11 cases, a surgical excision was carried out in 4 cases, and a 60 CO-applicator used for 3 patients. Three enucleations were carried out straight away. In this study we present the clinical characteristics of melanomas of young people, the therapy used, as well as the systematic analysis of the vital prognosis of the patients and of the functional prognosis of the eyes under treatment.

Adolescent↗
PubMed1992

[Treatment of eye tumors by accelerated proton beams. 7 years experience].

The therapeutic results of 1070 cases of intraocular tumors treated with an accelerated proton beam at the University Eye Clinic of Lausanne and at the Paul Scherrer Institute of Villigen are analysed. This total is composed of 981 cases of uveal melanomas treated by proton beam as first treatment modality, 42 cases of recurrent choroidal melanomas, 16 cases of conjunctival melanomas, 8 cases of choroidal hemangiomas, 18 cases of uveal metastases and of 5 other ocular tumors. The mortality rate at 5 years for tumors treated with an accelerated proton beam as first treatment modality was 13%, and the mortality rate of recurrent melanomas was 23%. The risk factor for life expectancy analysed with the Cox model pointed out that the largest tumor diameter, the width of the tumor, the presence of an extrocular extension and the age of the patient were the most significant parameters. The conclusions of this study are compared with those found in available literature.

Conjunctival Neoplasms↗
PubMed1992

[Treatment of exterior extension of choroid melanomas by accelerated proton beams].

Among the 934 patients with a choroidal melanoma treated in first intention with an accelerated proton beam since 1984, 41 (4.4%) presented an extrascleral extension, of which 11 were located anteriorly and 30 posteriorly. For these 30 cases, the diagnosis was made by B ultrasonography only when the volume of the extension was important, between 20 and 2280 mm3. The Cox model multi-variant analysis was used to study the statistically significant parameters in the development of an extrascleral extension. It appears that the maximal diameter of the intraocular tumor (p = 0.0012), the localisation of the anterior margin (p = 0.0304) and the age of the patients (p = 0.0097) are statistically meaningful. The 4 years' survival, studied with the Kaplan-Meier curves, is estimated at 60% for the patients with extrascleral extension and at 85% for the patients without. These results are similar to those of literature, whatever treatment is chosen (enucleation and radiotherapy, exenteration).

Adult↗
PubMed1992

[Ocular toxocara canis in a 30-year-old adult].

Pars plana vitrectomy was performed in a 30-year-old patient who presented a posterior traction detachment due to an inflammatory granuloma. The granuloma removed in toto during surgery revealed characteristic features of toxocariasis lesion (first case described in the literature). An ELISA test performed on a vitreous sample was strongly positive. Retinotomy around the granuloma was necessary to re-attach the retina and silicone oil was used as a tamponade for 4 months. VA improved from HM to 15/200 after silicone removal.

Adult↗
PubMed1992

[Loss of ganglion cells in the retina secondary to vincristine therapy].

We report the case of a 25-year-old black female from Zaire with AIDS diagnosed 2 years earlier. Nine months before her death, she was treated for a disseminated Kaposi sarcoma with vincristin, adryamycin and bleomycin. At that time, visual acuity was normal and ophthalmologic examination was unremarkable except for the presence of bilateral Drusen and a cotton wool spot OS. Three months after the onset of chemotherapy, the patient complained of progressive visual field constriction, which progressed to blindness within a 4 month period. Five months after the onset of the tri-therapy a bilateral CMV retinitis developed, which was successfully treated by intravitreous injections of ganciclovir. This therapy was stopped as soon as blindness was established, with subsequent massive bilateral recurrence of the CMV retinitis. Histologic examination showed complete atrophy of the retinal ganglion cells and areas of CMV retinitis. The optic nerve was demyelinated and exhibited astrocytic gliosis. Immunohistochemistry confirmed the presence of CMV in infected retina and revealed the absence in the optic nerve of the class III beta-tubulin isotype and of the 200 kd neurofilament subunit. In contrast, oculomotor nerves appeared intact. The presence of HIV in the eye and in the optic nerve was excluded using PCR technique. The retinal ganglion cell loss and optic nerve atrophy appeared to be purely degenerative in nature, since there was no evidence of vascular occlusion, inflammation or retrobulbar compressive process. We therefore conclude that blindness was caused by vincristine therapy. The patient actually received 22 mg of vincristin intravenously in 11 courses over 7 months, although discontinuation was recommended by us after 5 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Uveal melanomas and vitreous hemorrhage. Diagnosis and treatment].

In choroidal melanoma vitreous hemorrhage can occur as initial event or as complication of conservative therapy. To understand better these relations, four groups of cases were examined: 1.) 126 choroidal melanomas which were treated conservatively with Cobalt 60 applicator from 1969 till 1984. 2.) 715 choroidal melanomas which have been treated with proton-beam from 1984 to 1989. 3.) 7 tumors or pseudotumors for which for diagnostic purposes a phosphorus 32 test was necessary. 4.) 9 choroid melanomas which had conservative treatment and where vitrectomy was realized. The multifactorial analysis gave the following results: in vitreous hemorrhages occurring before treatment the thickness of the tumor represents the significant factor. In vitreous hemorrhages which occur after conservative treatment there is in the group of cobalt applicators important irradiation of the disc, as well as the thickness of the tumor and the age of the patient in the group with proton-beam irradiation. Vitreous bleeding occurring before or after therapy does not influence the vital prognosis in a negative way. We present here a therapeutic concept in cases of vitreous bleeding in choroid melanoma which is based both on our experience and on the indications of literature.

Adult↗
PubMed1991

Neuron-associated class III beta-tubulin isotype, microtubule-associated protein 2, and synaptophysin in human retinoblastomas in situ. Further immunohistochemical observations on the Flexner-Wintersteiner rosettes.

We studied by immunohistochemistry 26 retinoblastomas in situ using monoclonal antibodies specific for the neuron-associated class III beta-tubulin isotype (h beta 4), microtubule-associated protein 2 (MAP2), and synaptophysin. Anti-h beta 4 and anti-MAP2 immunostaining was consistently obtained in the Flexner-Wintersteiner rosettes, in fleurettes, in Homer Wright (neuroblastic) rosettes, and also variably among poorly differentiated tumor cells. A similar pattern of antisynaptophysin immunopositivity was seen, but was especially pronounced in the adluminal borders of cells forming the Flexner-Wintersteiner rosettes. The demonstration of h beta 4, MAP2, and synaptophysin epitopes in poorly differentiated and maturing neoplastic phenotypes in retinoblastomas attests to the neuronal character of this embryonal tumor. Immunoreactivity toward h beta 4 and MAP2 epitopes by poorly differentiated neoplastic cells may indicate early neuronal commitment in retinoblastoma. The consistent immunostaining of Flexner-Wintersteiner rosettes with monoclonal antibodies to h beta 4 and MAP2 is in keeping with the previous ultrastructural documentation of microtubules with a neuronal-like spatial organization present in the cells of these structures.

Adult↗
PubMed1990

[Melanoma of the conjunctiva and its treatment].

37 cases of conjunctival melanomas treated in the University Eye Clinic of Lausanne are analysed. This total is made of 20 men and 17 women aged between 19 and 81 years with a mean age of 54.7 years. Tumors were localized in the bulbar conjunctival in 27 cases, in the palpebral conjunctival in 2 cases and were diffuse in 8 cases. Cornea was infiltrated in 19 cases. In 21 cases, the first treatment was made in our service and 16 cases were recurrences following a treatment made elsewhere. The mortality rate to 5 years was 20%. In a multivariant analysis using the COX Model, the height of the tumor was the only significant parameter (p = 0.035) for life expectancy. Recurrence of the tumor (p = 0.060) and presence of a PAM (p = 0.652) were not significant parameters. Benefits of cryocoagulation and indications for a proton beam irradiation are discussed.

Adult↗